Revenue Cycle Management Specialist

Autism Diagnosis Group

Revenue Cycle Management Specialist managing full claims lifecycle for remote healthcare company. Ensuring accurate submissions, follow-ups, and denials resolutions in a fully remote setup.

Posted 7/20/2026contractRemote • 🌎 Anywhere in the WorldJuniorMid-Level💰 $700 - $2,000 per monthWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in the full claims lifecycle, including claim submission, denial resolution, and payment reconciliation, with a strong focus on accuracy in coding and compliance with billing regulations. Proficient in using billing software and clearinghouses to manage claims effectively while ensuring timely follow-up and resolution of discrepancies.

Highest-signal resume keywords

Medical Billing ExperienceCPT, HCPCS, ICD-10 Coding KnowledgeClaim Clearinghouse ProficiencyGoogle Sheets/Excel ExpertiseProactive Follow-Through

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingAR Follow-UpBilling Code VerificationError ScrubbingPayment PostingDenial ResolutionEOB ReviewRefund ProcessingCompliance with RegulationsPatient Insurance Verification

Soft Skills

Attention to DetailExcellent Communication SkillsTime ManagementProblem-SolvingCollaboration

Tools & Technologies

Billing SoftwareClaim ClearinghousesPayer PortalsGoogle SheetsExcel

Industry Keywords

Claims LifecycleBehavioral Health CodingTelehealth RegulationsCMS 1500 FormsHIPAA Compliance

About the role

Key responsibilities & impact

Own the full claims lifecycle – from claim submission and scrubbing to payment posting, AR follow-up, and denial resolution
Ensure that every claim is submitted accurately, every denial is challenged, and every payment is reconciled
Catch errors before claims go out, follow up relentlessly on unpaid claims, and identify patterns that prevent denials from happening in the first place
Prepare, review, and submit accurate claims to commercial payers (e.g., Aetna, Cigna, Blue Cross Blue Shield, UnitedHealthcare, Optum)
Verify and ensure the accuracy of billing codes (CPT, HCPCS, ICD-10) and modifiers for services rendered, with a focus on behavioral health and virtual care codes
Scrub claims for errors in demographics, eligibility, authorization, coding completeness, and payer-specific requirements before submission
Maintain up-to-date knowledge of commercial insurance billing requirements, with a focus on behavioral health and telehealth regulations
Use billing software and clearinghouses to process and track claims
Ensure timely filing requirements are met for all assigned payers
Monitor claim status and follow up on unpaid, underpaid, and denied claims promptly
Investigate and resolve claim discrepancies, denials, and appeals
Submit corrected claims and appeals when necessary
Maintain AR aging across assigned payer relationships – work buckets by age and priority
Review EOBs and denial trends to identify recurring issues and root causes
Generate reports for outstanding accounts receivable and payment trends
Post insurance and patient payments accurately (manual and electronic)
Reconcile ERA/EOB payments against expected reimbursement
Identify and resolve underpayments, overpayments, and credit balances
Process refunds to insurance and patients in compliance with regulations
Ensure all billing practices comply with federal, state, and local regulations
Verify patient insurance information, eligibility, and prior authorization requirements
Maintain accurate records of billing activities and patient accounts
Follow HIPAA regulations to ensure patient confidentiality
Support internal audits and quality reviews as requested
Collaborate with office staff, clinical teams, and payers to address billing and reimbursement issues
Provide clear communication to patients regarding their billing, payments, and financial responsibilities
Respond to inquiries from payers, patients, and colleagues in a professional and timely manner
Flag recurring pre-submission error patterns with recommendations for upstream fixes

Requirements

What you’ll need

2+ years of experience in medical billing, AR follow-up, claims processing, or revenue cycle operations
Knowledge of CPT, HCPCS, and ICD-10 coding
Experience with claim clearinghouses and payer portals
Experienced with CMS 1500 forms
Expert knowledge of Google Sheets/Excel to create their own reporting & analysis
Strong attention to detail – you catch errors before they become rejections
Ability to manage multiple claims and deadlines simultaneously
Familiarity with Availity and other payer portals
Proactive follow-through – you don't wait for payers to respond; you call them
Excellent written and spoken English communication skills
Reliable remote work setup with backup power and internet (EST hours)

Benefits

Comp & perks

Fully remote – work from anywhere outside the US
Competitive monthly compensation in USD
Ownership of a critical function with direct impact on revenue
Autonomy – we trust you to own your deadlines
Supportive, collaborative team culture